Browsing by Author "Karaman, Serap"

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Akut Lenfoblastik Lösemi Tedavisi Sonrası İyileşen Hastalarda Tiroid Fonksiyonları Açısından Geç Yan Etkiler
(2021) Bitkin, Eda Çelebi; Karaman, Serap
Amaç: Günümüzde hasta bakımındaki şartların iyileşmesi, gelişmiş laboratuvar olanakları ve risk sınıflandırılmasının daha iyi belirlenmesi gibi etkenlerle lösemi tanılı çocukların önemli bir kısmı erişkin yaşa ulaşmaktadır, ancak neredeyse her üç hastadan ikisinde uzun dönemde kanser tedavisine bağlı yan etkiler görülmektedir. Bu çalışmada pediatrik hematoloji birimimizde kemoterapi ve radyoterapi verilip tedavisi şifa ile sonuçlanan ve tedavi bitiminin üzerinden en az iki yıl geçmiş vakalarda kemoterapi ve radyoterapi’nin tiroid fonksiyonları üzerine olan etkilerinin incelenmesi amaçlanmıştır. Gereçler ve Yöntem: Akut lenfoblastik lösemi tanısı konulmuş, tanı anında 18 yaşın altında olan, Akut lenfoblastik lösemi tedavi protokollerine göre tedavi verilmiş, kemik iliği nakli yapılmamış, nüks olmayan, tedavi sonrası en az 2 yıllık takip süresi olan olgular dahil edilmiştir. Olguların poliklinik kontrollerinde yapılan tetkikleri ve demografik özellikleri dosyalarından ve elektronik kayıt sisteminden geriye dönük olarak kayıt edildi. Bulgular: Çalışmaya yaşları 5-18 yaş arası 45 hasta dahil edildi. On dört olguya kemoterapiye ilave olarak radyoterapi uygulanmış olup, bunların hepsine profilaktik kranial radyoterapi verilmişti. Olguların 6’sı 12 Gy, 8’i 18 Gy almışlardı. 45 olgunun 2’ sinde (% 4,4) TSH değerleri 5,5-10 μU / L arasındaydı. Hiçbir hastanın TSH >10 μU / L üzerinde değildi. Tüm hastaların sT4 düzeyleri normaldi. Tiroid fonksiyonları açısından karşılaştırıldığında kranial radyoterapi alan ve almayan hastalar da gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuç: Yapmış olduğumuz çalışmada kemoterapi ve profilaktik dozda kranial radyoterapi verilip iyileşen hastalarda troid fonksiyonları açısından geç yan etkiler saptanmamıştır.
Carina Angle Measurements for Diagnosis of Patent Ductus Arteriozus in Newborn Infants
(2012) Karaman, Serap; Üner, Abdurrahman
Duktus Arteriosus'a (PDA) yatak başında tanı konulması, özellikle hâlihazırda ekokardiyografi çekme imkânının olmadığı durumlarda önemini korumaya devam etmektedir. Bu çalışmamızın amacı; bir akciğer grafisindegörülen,sol ana bronkusun çıktığı yerde genişlemiş olan Karina Açısının (KA) muhtemel bir PDA varlığını destekleyip desteklemediğini değerlendirmekti. Klinik ve ekokardiyografik olarak PDA tanısı almış olup, hemodinamik olarak anlamlı olan ve 37 hafta altındaki 69 infantdan çalışma grubu oluşturuldu. Çalışma grubundaki 40 infant retrospektif, 20 infant prospektif olarak incelendi. Kontrol grubu 60 vakadan oluşturuldu. 69 PDA'lı ve 60'ında herhangi bir duktus bulgusu olmayan infantta, her iki ana bronş arasındaki açının karina seviyesinde ölçülmesi suretiyle sol bronkusun yerleşimi değerlendirildi.Her iki gurup karşılaştırıldığında; PDA grubunda anlamlı derecede bir Karina Açısı (KA2) genişlemesi mevcuttu, bu grupta çeyrek değer genişliği (IQR) 69-108 º, ortanca değer (median) 89º ve ortalama değer (mean) 87.26 º (± 7.01 º) iken kontrol gurubunda bu değerler sırasıyla 57-89º, 66.5º ve 67.4º (± 7.33º) idi (P < 0.001). Cut-off noktası 73.5 º olarak kabul edildiğinde, en yüksek sensitivite (%97) ve spesifite (%55) değerini ifade etmektedir. Biz, artmış olan KA değeri ile PDA'nın ortaya çıkışı arasında anlamlı ve pozitif bir ilişki tespit ettik (P< 0.01). PDA yokken olan karina açısı (KA1) çeyrek değer genişliği (IQR) 58-85 º, ortanca değer (median) 73 º ve ortalama değer (mean) 72,2 º (± 4.9 º), PDA saptandağında çeyrek değer genişliği (IQR) 69-108 º, ortanca değer (median) 89º ve ortalama değer (mean) 87.2 º (±7.01 º) , PDA kapandığında bu değerler sırasıyla 63-88º, 74.5 º ve 74.7º (± 6.4 º) idi (P< 0.001). PDA' rezolüsyonundan sonra KA'da meydana gelen değişiklikleri de inceledik. DA'nın patent durumdayken ölçülen 87.2 º (± 7 º) değeri ile karşılaştırıldığında, KA'nın 74.7 º (± 6.4 º) değerine gerilediği görüldü (P< 0.001).Biz, olası bir PDA varlığının göğüs grafisinde KA genişlemesi şeklinde ortaya çıkma ihtimalinin arttığını ortaya koyduk. Benzer şekilde, KA'nın 73.5 º'den daha dar olması %93 NPD (Negatif prediktif değer) ihtimali ile PDA tanısını ekarte etmektedir. PDA tanısının konmasında; KA değeri, güvenilir kolay ulaşılabilen ve bir araçtır.Anahtar Kelimeler: PDA, Karina açısı değeri, Prematürite, Ekokardiografi
Clinical and Laboratory Findings of Paediatric Patients With Brucellosis
(Galenos Yayincilik, 2021) Karaman, Serap; Bitkin, Eda Celebi; Sonmez, Bulent; Basaranoglu, Murat; Karaman, Kamuran; Tuncer, Oguz
Objective: Brucellosis is the most common bacterial zoonotic disease transmitted via unpasteurised milk and dairy products from infected animals. This study aimed to evaluate paediatric patients treated for brucellosis and followed for 2 years. Materials and Methods: The records of 73 patients with childhood brucellosis who had undergone treatment and follow-up for 2 years were retrospectively evaluated. Results: The patient age ranged from 1 to 14 years, with 39 boys (53%) and 34 girls (47%). Fever (94%) was the first common symptom. Other symptoms, in the order of frequency, were myalgia (80%), arthralgia (75%), fatigue (38%) and anorexia (33%). Complications included sacroiliitis (12%), hemophagocytic lymphohistiocytosis (4%), epididymo-orchitis (1.3%), focal abscess (1.3 %) and meningitis (1.3%). Splenomegaly, hepatomegaly and lymphadenopathy (24%, 33% and 5%, respectively) were also reported. Moreover, 18% of the patients had hepatosplenomegaly at initial admission. Dermatological involvement revealed maculopapular rash in 4.1% and petechial rash in 9.6% of patients. Body weight loss was observed in 14% of the cases. In addition, 76.3% and 23.7% of the patients had acute and sub-acute forms, respectively. Conclusion: Brucellosis can display several different clinical presentations. This diversity can lead to diagnostic delay. In settlements where the disease is common, patients with fever and joint pain should be treated early and the disease should be ruled out.
Evaluation of Pubertal and Pathological Gynaecomastia in Children: a Single-Center Experience
(Wiley, 2021) Bitkin, Eda Celebi; Aymelek, Huri Sema; Karaman, Serap
Gynaecomastia in adolescents is a benign glandular proliferation of the male breast. Secondary causes of gynaecomastia in adolescents are relatively rare and may result from a wide variety of rare pathological conditions. Among these, klinefelter syndrome, complete androgen resistance, adrenal tumours and oestrogen-secreting testicular tumours, hypogonadism, hyperthyroidism, kidney disease and medications play a role in aetiology. The aim of our study is to review the demographic characteristics, hormone profile, aetiological characteristics of paediatric gynaecomastia patients admitted to a single center and to determine the frequency of pathological gynaecomastia. Forty-three male patients with gynaecomastia who applied to the paediatric endocrinology outpatient clinic were included in our study. Demographic characteristics, physical examination findings, hormone profile, breast ultrasonography and karyotype results of the patients were recorded. There were 43 male patients in our study. Thirty-six (83.7%) of the patients were pubertal gynaecomastia, 7 (16.2%) were pathological gynaecomastia. Three of the patients with pathological gynaecomastia were prepubertal gynaecomastia, 2 had klinefelter syndrome, 1 had hypergonadotropic hypogonadism after acute lymphoblastic leukaemia treatment and 1 had gynaecomastia after spirololactone use. Careful evaluation of patients with gynaecomastia is especially important in detecting pathological types. We reported the rare prepubertal gynaecomastia and klinefelter frequency in our study.
Fekaloid Umblikal Drenajı Olan Patent Omfalomezenterik Kanal Tanılı Bir Yenidoğan
(2023) Aycan, Nur; Yürektürk, Eyyüp; Ateş, Ali; Ayengin, Kemal; Toplar, Emel Nadya; Karaman, Serap; Tuncer, Oğuz
Yenidoğan döneminde umblikal anomaliler oldukça sık görülmektedir. Göbek patolojili olgularda embriolojik gelişim basamaklarını ve anatomiyi bilmek doğru tanı ve tedavi için esastır. Bu anomalilerin nadir bir tipi patent omfalomezenterik kanal olup hayatın ilk gününde tanı koyulabilir. Yenidoğanın geçici taşipnesi nedeniyle ünitemize yatırılan miadında bir erkek bebeğin umbilikustan sarı-yeşil renkli, köpüklü fekaloid drenajı olduğu görüldü. Göbek kordonunda vişne renkli mukoza ile uyumlu doku görüntüsü mevcuttu. Tetkikleri sonucu patent omfalomezenterik kanal tanısı koyularak opere edildi. Umblikus anomalileri arasında nadir olarak görülen patent omfalomezenterik kanal anomalisi olgusunu bildirmek istedik.
Identification of Three Novel Pathogenic Itga2b and One Novel Pathogenic Itgb3 Mutations in Patients With Hereditary Glanzmann's Thrombasthenia Living in Eastern Turkey
(Taylor & Francis inc, 2021) Karaman, Kamuran; Yurekturk, Eyup; Geylan, Hadi; Yasar, Akkiz Sahin; Karaman, Serap; Aymelek, Huri Sema; Oner, Ahmet Fayik
Glanzmann's thrombasthenia (GT) is an autosomal recessive disorder in which the underlying problem is the lack or dysfunction of the GpIIb/IIIa receptor on the platelet surface. The present study determines the genetic mutation typology and analyzes the association between mutation types and clinical findings in patients diagnosed with GT who were followed up in Department of Pediatric Hematology of the Yuzuncu Yil University School of Medicine. The medical charts of 17 patients who underwent therapy and that were followed up in the Department of Pediatric Hematology of the Yuzuncu Yil University Dursun Odabas Medical Center between January 2008 and April 2018 were reviewed retrospectively. Data on such patient characteristics as present genetic mutations, age, gender, age at diagnosis, presenting symptoms, clinical findings, and platelet count and volume were garnered from the patient records. Of the 12 patients identified with genetic mutations, six had the same type of mutation, while four were identified with novel mutations that have to date not been defined in literature. Of these four mutations, three were located in the ITGA2B gene and one in the ITGB3 gene. The present study identified no significant association between the genetic and clinical findings of the patients. Novel mutations were identified in four cases in the present study. No association was found between the mutation type, and the bleeding scores and bleeding phenotypes of the patients. Further studies involving a larger number of patients are required to determine the relationship between the genotypes and clinical findings in patients with GT.
Indicator of Early Kidney Injury in Adolescents With Polycystic Ovary Syndrome: Can Urine Ngal Level Be
(Taylor & Francis Ltd, 2021) Karaman, Serap; Sabanciogullari, Enis; Karaman, Erbil; Basaranoglu, Murat; Cetin, Mecnun; Karaman, Kamuran
Introduction and Purpose:The Urinary Neutrophil-gelatinase associated lipocalin (NGAL) levels which are a biomarker for early diagnosis of kidney damage that may develop in patients with Polycystic Ovary Syndrome (PCOS) were investigated in the study. Material and Methods:The 30 patients diagnosed with Polycystic Ovarian Syndrome between the ages of 13 and 18 who applied to the Yuzuncu Yil University General Children's Outpatient Clinic were included in the PCOS group and 30 healthy adolescents without any known acute or chronic illness and drug use were included in the control group. Findings:Urine NGAL value was 842.204 +/- 21.561 in PCOS group and 775.379 +/- 23.98 in control group. NGAL level in PCOS group was statistically significantly higher than control group (p: .045). When we examine the relationship between dyslipidemia and PCOS; While dyslipidemia was positive in 10 (33.7%) patients in the PCOS group, it was negative in 20 (66.7%) patients. While 1 patient had dyslipidemia, 29 patients did not have dyslipidemia in the control group. A significant relationship was found between dyslipidemia and PCOS (p: .005). Conclusion:We found that subclinical kidney dysfunction started in early stage patients in PCOS in our study. The urine NGAL level was thought to increase in response to increased oxidative stress in PCOS. We found no relationship between, insulin resistance and urea, BUN, creatinine and NGAL levels. However, we found a negative correlation between NGAL level and LDL. In addition, dyslipidemia, insulin resistance and ALT elevation were detected in the PCOS group.
İndirekt Hiperbilirubinemili Term Yenidoğanların Etiyolojik Değerlendirmesi
(2024) Basaranoglu, Murat; Batu, Utku; Aycan, Nur; Yurekturk, Eyyup; Karaman, Serap; Tuncer, Oguz
Amaç: İndirekt hiperbilirubinemi, yenidoğanlarda sık görülen birçok risk faktörü olan bir hastalıktır. Çalışmamızda, yenidoğan yoğun bakım ünitemize indirekt hiperbilirubinemi tanısı ile yatırılan hastaların öykü, fizik muayene ve tetkiklerinin, hastaların tedavi ve takipleri üzerine olan etkileri incelenmesi amaçlandı. Yöntemler: Kesitsel ve retrospektif olarak yapılan çalışmamıza, miadında doğan, indirekt hiperbilirunemi tanısıyla yatırılan 226 hasta alındı. Hasta dosyalarından öyküleri, fizik muayene ve tetkik verileri değerlendirildi. Bulgular: Çalışmaya alınan 226 hastanın 126’sı (%55,8) erkek, 100’ü (%44,2) kızdı. Gestasyon haftaları ortalama 38,3±0,4 hafta, ortalama doğum ağırlıkları 3146±32 gramdı. Hastaların yatış anındaki ortalama postnatal günleri 4,1±0,1 gün, yatış bilirubinleri 17,1±0,2 mg/dl, fototerapi alma süreleri ise 38,2±1 saat, yatış sırasında tartı kaybı ise %3,7±0,3 olarak görüldü. Hastalardaki en sık tanının ABO uygunsuzluğu (%27,9) olduğu görüldü. Tartı kaybı olan hastaların bilirubin düzeyleri istatiksel açıdan anlamlı yüksekti. Kan uyuşmazlığı ve diğer tanılar karşılaştırıldığında; kan uyuşmazlığı olan hastalarda bilirübin ve hemoglobin düzeyi ve yatış anındaki postnatal yaş istatistiksel açıdan anlamlı daha düşük, yatış süresi ise istatistiksel açıdan anlamlı daha yüksekti. Sonuç: Cinsiyet ve doğum şekli ile yatış total bilirübin ve fototerapi alma süresi arasında anlamlı ilişki görülmedi. Tartı kaybı olan hastaların olmayanlara göre yatış total bilirübin istatistiksel olarak daha yüksekti. Ek olarak ABO uygunsuzluğu olan hastaların yatış sürelerinin de diğer tanılarla yatan hastalara göre istatistiksel açıdan anlamlı daha uzun olduğu görüldü.
Is Low-Level Laser Therapy a Candidate To Be a Good Alternative in the Treatment of Mucositis in Childhood Leukemia
(Lippincott Williams & Wilkins, 2022) Karaman, Kamuran; Sarica, Ayca; Tunc, Serap Keskin; Karaman, Serap
Background and Aim: Oral mucositis (OM) is a common side effect of systemic chemotherapy (CT) in cancer patients. The aim was to evaluate the effect of low-level laser therapy (LLLT) for the treatment of CT-induced OM children. Patients and Methods: The study was carried out in 40 pediatric patients 3 to 18 years of age, who were hospitalized for the diagnosis of leukemia and underwent CT between June 1, 2019, and December 31, 2019. They were randomly divided into 2 groups with 20 cases in each group. The LLLT group was treated with GaAlAs diode laser (l): 830 nm (infrared), power: 150 mW, dose: 4.5 J/cm(2) and the control group underwent bicarbonate treatment. Patients received intervention for 3 days. The grade of OM was clinically assessed by the World Health Organization (WHO) Common Toxicity Criteria Scale. Visual Analog Scale was used on the same days with OM grade to evaluate the pain status. Results: While there was no significant difference between the groups in terms of OM grade at the beginning of the treatment and on the first, second, fourth, and 11th days of the treatment, the average OM grade of the LLLT group was found to be statistically significantly lower on the third, fifth, sixth, and seventh days of the treatment. The Visual Analog Scale score of the LLLT group was statistically significantly lower compared with the control group at all examinations starting from the first day of treatment (P<0.05). Conclusion: In the treatment of oral OM that occurs in children after CT, both standard care and LLLT treatment improve the grade and pain of OM.
Otizmli Çocuklarda Doğum Öyküsü, Anne Sütü Alma Süresi, Televizyon İle Tanışma Yaşı, Televizyon, Akıllı Telefon ve Tablet Kullanım Alışkanlıklarının İncelenmesi
(2020) Karaman, Serap; Kurt, Tuğba; Kamaşak, Tülay; Direk, Meltem
Amaç: Otizm spektrum bozuklukları prevalansında son yirmiyıl içerisinde ortaya çıkan artış çevresel koşullardakideğişiklikler ile otizm arasındaki ilişkinin önemini yenidentartışmaya açmıştır. Bu çalışma ile, çevresel bazı riskfaktörlerini otizm hastalarında geriye dönük incelemeyihedefledik.Gereç ve Yöntemler: Sağlık Bilimleri Üniversitesi Van Eğitimve Araştırma Hastanesi Çocuk Nöroloji Polikliniği’nde otizmtanısı ile takip edilmekte olan hastalar geriye dönük olaraktarandı. Benzer yaş grubundaki sağlıklı çocuklar kontrol grubuolarak alındı. Bu iki grup; hipoksi ve prematürite varlığı, annesütü alımı ve süresi, televizyon ile tanışma yaşı, televizyon,akıllı telefon ve tablet kullanım süreleri açısından incelendi.Bulgular: Çalışmaya otizm grubunda 66, kontrol grubunda 60olmak üzere toplam 126 çocuk alındı. Gruplar arasındaprematürite öyküsü ve hipoksik etkilenim açısından farkizlenmedi. Anne sütü hiç almayan çocuklar otizm grubundadaha yüksek sayıdaydı (p=0.018). Otizm tanısı alan hastalarındaha kısa süre anne sütü almış oldukları görüldü(otizm:8.489.19 ay, kontrol:13.188.64 ay, p=0.001). Otizmgrubunun ve kontrol grubunun televizyon ile tanışma yaşlarıarasında belirgin bir farklılık gözlenmedi. Otizm tanılı gruptadört saat ve üzeri televizyon izleme oranı belirgin derecedeyüksekti (p=0.020). Benzer şekilde tablet ve akıllı telefon ilevakit geçirme süreleri otizm tanılı hastalarda anlamlı derecedeyüksekti (p=0.001).Sonuç: Anne sütü almamış olmak ya da kısa süre anne sütü ilebeslenme, otizm riski ile ilişkilendirilebilir. Televizyon, tabletve akıllı telefon gibi ekran maruziyetlerinde artmış süre, otizmeyatkınlığı olan çocuklarda kliniğin ortaya çıkmasınıkolaylaştıran ya da tetikleyen bir faktör olabilir.
Oxidative and Antioxidative Biomarker Profiles in Neonatal Hypoxic-Ischemic Encephalopathy: Insights for Pathophysiology and Treatment Strategies
(int Scientific information, inc, 2024) Aycan, Nur; Demir, Derya Cay; Yurekturk, Eyyup; Basaranoglu, Murat; Karaman, Serap; Tuncer, Oguz
Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of perinatal and postnatal morbidity and mortality worldwide. Catalase (CAT) activity detection is used to determine levels of inflammation and oxidative stress. Glutathione (GSH) is the most critical non-enzymatic endogenous antioxidant. Lipid peroxidation levels marked after hypoxia can be detected based on the level of malondialdehyde (MDA). Ischemia-modified albumin (IMA) is considered a biomarker for cardiac ischemia and is known to increase in the liver, brain, and kidney in states of insufficient oxygenation. We aimed to explain the results and relations between the oxidant and antioxidants to detail oxidant-antioxidant balance and cellular mechanisms. Material/Methods: Serum levels of IMA and MDA, as an oxidative stress marker, and CAT and GSH, as antioxidant enzymes, were measured in first blood samples of 59 neonates diagnosed with HIE, with pH <7, base excess >12, and APGAR scores. Results: Neonates who were >= 37 weeks of gestation and had hypoxia were included. Compared with healthy newborns (n=32), CAT was statistically significantly lower in the hypoxia group (P=0.0001), P =0.0001), while MDA serum levels were significantly higher in neonates with hypoxia (P=0.01). P =0.01). There was no difference between hypoxic and healthy neonates in GSH and IMA measurements (P=0.054, P =0.054, P =0.19 respectively). Conclusions: HIE pathophysiology involves oxidative stress and mitochondrial energy production failure. Explaining the pathways between oxidant-antioxidant balance and cell death, which explains the pathophysiology of HIE, is essential to develop treatment strategies that will minimize the effects of oxygen deprivation on other body organs, especially the brain.
Respiratory Syncytial Virus Dominance in Pneumonia Cases After Removal of Pandemic Restrictions
(2023) Aycan, Nur; Yürektürk, Eyyüp; Ateş, Ali; Toplar, Emel Nadya; Karaman, Serap; Tuncer, Oğuz
Aim: Respiratory syncytial virus is one of the most important causes of lower respiratory tract infections, with high mortality and morbidity in infants and children. It can cause airway inflammation, mucosal edema, and small airway collapse. Materials and Methods: We evaluated the clinical and demographic characteristics of newborns aged 0-30 days who were hospitalized in Yüzüncü Yıl University Neonatal Intensive Care Unit due to lower respiratory tract infections and whose respiratory syncytial virus test was positive between 15/December/2022 and 15/February/2023. Results: Between the specified dates, 29 patients diagnosed with lower respiratory tract infections were admitted to our neonatal unit. Of the oral/nasopharyngeal swab samples sent from all of these patients, one was positive for SARS-CoV-2, one for adenovirus, one for influenza A/B, and 18 (62%) respiratory syncytial virus. The weeks of the birth of the patients who were found to be positive for respiratory syncytial virus A/B were 36.72±1.48. The number of days they spent in the hospital was 6.72±1.6, 2(11.1%) patients required intubation, and 7(38.8%) patients required noninvasive respiratory support. One patient presented with convulsions at home, and cough and fever symptoms appeared on the second day of hospitalization. All patients recovered with oxygen support, hydration, and supportive treatment and were discharged. Conclusion: The most common cause in neonates was found to be a respiratory syncytial virus. Early diagnosis and treatment are important in patients with suspected lower tract viral infections. Unnecessary antibiotic use and the spread of the disease should be prevented by increasing access to viral tests.
Rituximab in Pediatric B-Cell Non-Hodgkin Lymphoma: Clinical Outcomes and Prognostic Implications
(Galenos Publ House, 2025) Akyol, Sefika; Guzel, Turan; Ozcan, Alper; Karaman, Serap; Orhan, Mehmet Fatih; Uzel, Veysiye Hulya; Unal, Ekrem
Objective: B-cell Non-Hodgkin Lymphoma (B-NHL) is an aggressive malignancy in children requiring prompt multidisciplinary management. This retrospective cohort study aims to evaluate the clinical characteristics, treatment outcomes, and impact of rituximab (RTX) in pediatric B-NHL patients. Methods: We retrospectively analyzed 62 pediatric B-NHL patients treated at tertiary centers. Patient demographics, clinical presentation, histopathological subtypes, disease stage, treatment regimens, and survival outcomes were assessed. Event-free survival (EFS) and overall survival (OS) rates were analyzed based on lactate dehydrogenase (LDH) levels and RTX administration. Results: The mean age at diagnosis was 8.73 +/- 4.3 years, with a male predominance (79%). The most common histological subtype was Burkitt lymphoma (BL) (53.2%), followed by diffuse large B-cell lymphoma (DLBCL) (33.8%). Advanced-stage disease (III-IV) was observed in 74.1% of cases. RTX was administered in 72.5% of patients, with a mean of 5.1 +/- 2.7 doses. Febrile neutropenia (FEN) was noted in 74.1%, with intensive care unit (ICU) admission required for seven patients. Mortality was observed in 12 (19.3%) patients, including all patients with primary immunodeficiency (PID). The 5-year EFS for the entire cohort was 67.2%, and OS was 81.3%. Patients with LDH <400 U/L had superior 5-year EFS (88.9%) and OS (96.3%) compared to those with LDH >400 U/L (EFS: 49.6%, OS: 70.7%; p=0.004 and p=0.015, respectively). In RTX-treated patients without PID, EFS was 76.5% versus 73.2% in those without RTX, but the difference was not statistically significant (p=0.53). Conclusions: Although not statistically significant, EFS was found to be higher in the RTX-treated group, suggesting that adding RTX to standard chemotherapy regimens may improve survival, particularly for high-risk patients, though its benefit in low-risk cases remains uncertain. Despite improved survival, patients with PID had poor outcomes, likely due to increased infections and disseminated disease. Risk-adapted, targeted treatment strategies are essential for optimizing outcomes in pediatric B-NHL. Further large-scale, randomized controlled trials are needed to confirm the efficacy of RTX in different risk groups and to optimize treatment regimens for pediatric B-NHL.
Role of Netrin-1 in Staging Hypoxic Ischemic Encephalopathy
(Assoc Medica Brasileira, 2025) Aycan, Nur; Demir, Derya Cay; Yurekturk, Eyyup; Basaranoglu, Murat; Karaman, Serap; Tuncer, Oguz
OBJECTIVE: The diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy are established through clinical evidence and laboratory, imaging, and electrophysiological assessments of the nervous system. Netrin-1 was the first axon guidance molecule identified as a critical component of embryonic development in vertebrates and has a solid chemotropic function for angiogenesis, morphogenesis, cell migration, and axonal guidance. It was hypothesized that Netrin-1 will differ at different hypoxic-ischemic encephalopathy stages. METHODS: This study included 75 hospitalized hypoxic-ischemic encephalopathy newborns and 48 healthy newborns born at the same hospital and followed up only by their mothers. Demographic, laboratory, and Netrin-1 data were evaluated for all hypoxic-ischemic encephalopathy stages. RESULTS: Serum Netrin-1 concentrations were significantly greater in patients with moderate and severe hypoxic-ischemic encephalopathy who underwent therapeutic hypothermia than in controls and patients with severe hypoxic-ischemic encephalopathy. However, serum Netrin-1 concentrations were not significantly greater in patients with mild hypoxic-ischemic encephalopathy than in controls. In 75 hypoxic-ischemic encephalopathy patients, correlations of Netrin-1 with lactate, uric acid, and lactate dehydrogenase were statistically significant (p=0.0001, 0.008, and 0.043, respectively). CONCLUSION: Netrin-1 significantly increased in moderate and severe patients. Therefore, this marker could be a biomarker for staging hypoxicischemic encephalopathy and therapeutic hypothermia and predicting the prognosis of neonatal hypoxic-ischemic encephalopathy patients.
Seroprevalence of Hepatitis a and Associated Factors Among 1-15 Year Old Children in Eastern Turkey
(E-century Publishing Corp, 2015) Karaman, Serap; Karaman, Kamuran; Kizilyildiz, Baran Serdar; Ceylan, Nesrin; Kaba, Sultan; Parlak, Mehmet; Ceylan, Abdullah
Background: Hepatitis A is a common infectious disease during childhood worldwide. Recently, great deal of changes in the epidemiology has been reported. The seroepidemiologic studies of this infection are not sufficient in Eastern region of Turkey. Objective: To investigate the seroprevalence and association with socio-demographic variables of hepatitis A in 1-15 year old children in Van. Patients and Methods: This study was performed on 510 one to fifteen year old children from outpatient pediatric clinics in Yuzuncu Yil University, Faculty of Medicine during last three months of 2009. Anti-HAV IgG was measured in sera by enzyme-linked immunosorbent assay. The information about subjects was recorded on standardized forms and a chart review survey was performed. Results: The overall ratio for seropositivity was 54.9%. Statistical significance was found between hepatitis A seroprevalence and age, collective use of domestic items, fresh water resources, localization and type of toilet and the number of households. Conclusion: This study provided the most recent data of seropositivity and revealed the preliminary indication of epidemiological shift in seroprevalence of Hepatitis A virus in a region with high endemicity.
Tip 1 Diyabet Mellitus Olgularının Değerlendirilmesi
(2017) Bala, Keziban Aslı; Kocaman, Selami Kocaman; Aslan, Oktay; Karaman, Serap; Didin, Muazzez; Kaba, Sultan; Doğan, Murat
Amaç: Retrospektif olarak planlanan çalışmada; 0-18 yaş arası tip 1 diyabetes mellituslu (DM) hastalarda demografik özellikler, tanı yaşları, metabolik kontrol durumları, tanı anındaki bulguları ve diyabete eşlik eden hastalıklarının olup olmadığının belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmamıza, Yüzüncü Yıl Üniversitesi Tıp Fakültesi çocuk endokrinoloji polikliniğimizden takip ve tedavileri yapılan; \"WHO\" kriterlerine göre tanı konulmuş eski ve yeni tanılı 0-18 yaş aralığında, 101 tip 1 DM hastası çocuk alındı. Bulgular: Tip 1 DM' li hastaların 43'ü (%42.6) kız, 58'i (%57.4) erkekti. Tanı yaşı ortalaması 8.3 ± 8.0 yıl (min:1 yıl, max: 16 yıl) idi. Hastaların başvuru anında %51.6' sında diyabetik ketoasidoz, %27.7' sinde hiperglisemi ve %20.7' sinde ketonemi saptandı. Eşlik eden otoimmün hastalıklar açısından değerlendirildiğinde tip 1 DM'lu 6 kişide (5.9%) çölyak hastalığı tespit edilmişken, 95 kişide (94.1%) eşlik eden herhangi bir otoimmün hastalık saptanmamıştı. Tip 1 DM'lu çocukların 2'sinde (1.9%) diyabetik nefropati gelişmişken, 99'unda (98.1%) diyabetin herhangi bir kronik komplikasyonu saptanmamıştı. Hastaların 8'i (7.9%) iyi metabolik kontrollü, 29'u (28.7%) orta metabolik kontrollü, 64'ü (63.4%) kötü metabolik kontrollü olarak saptandı. Sonuçlar: Çalışmamızda tip 1 DM' nin ilimizde erkek çocuklarda kızlara göre daha sık olduğu, tanıda ketoasidozla başvurunun daha çok görüldüğü, diyabetin ortaya çıktığı doruk yaşların 5 yaş öncesi ve erken puberte yaşları olduğu, en sık eşlik eden otoimmun hastalığın çölyak hastalğı ve en sık kronik komplikasyon olarak da nefropati geliştiği saptanmıştır.
Wiskott-Aldrich Syndrome: Two Case Reports With a Novel Mutation
(Taylor & Francis inc, 2017) Kamuran, Karaman; Cetin, Mecnun; Geylan, Hadi; Karaman, Serap; Demir, Nihat; Yurekturk, Eyyup; Tuncer, Oguz
Background: The Wiskott-Aldrich syndrome (WAS) is X-linked recessive disorder associated with microplatelet thrombocytopenia, eczema, infections, and an increased risk of autoimmunity and lymphoid neoplasia. The originally described features of WAS include susceptibility to infections, microthrombocytopenia, and eczema.Aim: In this case report, we present our experience about two cases diagnosed with a new mutation.Methods: We report phenotypical and laboratory description of two cases with WAS.Results: We, for the first time, detected a new hemizygote mutation of WAS gene (NM_000377.2 p.M393lfs(*)102 (c.1178dupT)) in two patients. The first case was an 11-month-old boy presenting with complaints of recurrent soft tissue infection, ear infection, anemia, and thrombocytopenia with a low platelet volume. The second case was a 2-month-old boy presenting with thrombocytopenia and a low platelet volume. Both cases were the first-degree relatives: they were cousins and their mothers were sisters.Conclusion: Herein, we report two cases of WAS and a new gene mutation which would disrupt the WAS protein function within the Polyproline (PPP) domain. This report adds to the growing number of mutations which cause complex clinical manifestations associated with WAS.